Residual small artery impairment in hypertensive patients with normal albumin–creatinine ratio. (3rd May 2016)

• Record Type: Journal Article
• Authors: Eftekhari, Ashkan; Wiggers, Signe Nielsen; Mathiassen, Ole Norling; Christensen, Kent Lodberg
• Is Part Of: Scandinavian cardiovascular journal. Volume 50:Number 3(2016:Jun.)
• Page Start: 167
• Page End: 171
• Publication Date: 2016-05-03
• Subjects: Essential hypertension -- forearm minimum vascular resistance -- pulse wave velocity -- urine albumin excretion; Cardiovascular system -- Diseases -- Periodicals; 617.41
• DOI: 10.3109/14017431.2016.1152397
• Languages: English
• ISSNs: 1401-7431

Abstract

Abstract: Objectives Previous studies have suggested that urine albumin excretion (UAE) mirrors generalized vascular damage; however, it is unclear to which degree UAE mirrors small artery impairment.Design We enrolled 67 patients with uncomplicated essential hypertension (EH) during stable antihypertensive therapy. F-Rmin, ACR on three non-consecutive morning urine samples, pulse wave velocity (PWV), and 24-h ambulatory blood pressure (ABPM) were measured.Results ACR was low (0.39 and 0.30–0.60), but abnormal small artery structure defined as F-Rmin > mean + 2 standard deviations of normotensive value (1.99 + 1 mmHg min/(ml/100 ml)) was present in 45% ( n = 30). The mean F-Rmin was 2.89 ± 0.09 mmHg min/(ml/100 ml). ACR correlated significantly to PWV (r 2 = 0.11; p < 0.05) and pulse pressure (r 2 = 0.15; p < 0.001), but not F-Rmin and (r 2 = 0.05, p = 0.07).Conclusions Abnormal microvascular structure was present even in EH patients with low UAE. ACR correlated to arterial stiffness and not to small artery structure; therefore, UEA did not reflect microvascular damage in this population. ACR and F-Rmin thus reflect two distinct types of subclinical organ damage in hypertension.